| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
12,813 |
12,252 |
$713K |
| E0260 |
Hosp bed semi-electr w/ matt |
17,298 |
16,765 |
$533K |
| K0001 |
Standard wheelchair |
19,687 |
19,008 |
$328K |
| E2611 |
Gen use back cush wdth <22in |
2,347 |
2,234 |
$231K |
| K0003 |
Lightweight wheelchair |
6,305 |
6,128 |
$157K |
| E0601 |
Cont airway pressure device |
3,848 |
3,810 |
$148K |
| E0143 |
Walker folding wheeled w/o s |
4,758 |
4,588 |
$143K |
| E0303 |
Hosp bed hvy dty xtra wide |
1,386 |
1,319 |
$114K |
| E0570 |
Nebulizer with compression |
3,709 |
3,527 |
$103K |
| A7030 |
Cpap full face mask |
1,630 |
1,578 |
$91K |
| E0466 |
Home vent non-invasive inter |
329 |
328 |
$88K |
| E0971 |
Wheelchair anti-tipping devi |
3,659 |
2,757 |
$84K |
| E0240 |
Bath/shower chair |
2,606 |
2,512 |
$76K |
| E0247 |
Trans bench w/wo comm open |
1,761 |
1,637 |
$74K |
| A7031 |
Replacement facemask interfa |
2,918 |
2,842 |
$74K |
| K0006 |
Heavy duty wheelchair |
2,402 |
2,285 |
$74K |
| E0185 |
Gel pressure mattress pad |
1,488 |
1,412 |
$71K |
| K0007 |
Extra heavy duty wheelchair |
1,017 |
968 |
$71K |
| E2601 |
Gen w/c cushion wdth < 22 in |
3,117 |
2,962 |
$66K |
| E0163 |
Commode chair with fixed arm |
3,230 |
3,101 |
$63K |
| E0630 |
Patient lift hydraulic |
4,606 |
4,428 |
$58K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
617 |
578 |
$54K |
| A4604 |
Tubing with heating element |
2,657 |
2,592 |
$50K |
| E0562 |
Humidifier heated used w pap |
498 |
491 |
$49K |
| E0277 |
Powered pres-redu air mattrs |
1,238 |
1,195 |
$46K |
| E1028 |
W/c manual swingaway |
511 |
424 |
$45K |
| A7034 |
Nasal application device |
1,122 |
1,099 |
$44K |
| E0973 |
W/ch access det adj armrest |
1,334 |
986 |
$42K |
| E0961 |
Wheelchair brake extension |
2,615 |
2,054 |
$33K |
| E0431 |
Portable gaseous 02 |
4,120 |
3,919 |
$33K |
| K0738 |
Portable gas oxygen system |
3,213 |
3,029 |
$32K |
| K0195 |
Elevating whlchair leg rests |
9,225 |
8,841 |
$29K |
| E1392 |
Portable oxygen concentrator |
3,981 |
3,870 |
$27K |
| E0149 |
Heavy duty wheeled walker |
1,437 |
1,367 |
$27K |
| A7035 |
Pos airway press headgear |
1,996 |
1,945 |
$24K |
| A7038 |
Pos airway pressure filter |
6,147 |
5,992 |
$23K |
| A7032 |
Replacement nasal cushion |
886 |
877 |
$22K |
| E0261 |
Hosp bed semi-electr w/o mat |
580 |
547 |
$19K |
| A7033 |
Replacement nasal pillows |
1,036 |
1,015 |
$17K |
| E0955 |
Cushioned headrest |
267 |
251 |
$13K |
| E0156 |
Walker seat attachment |
1,958 |
1,899 |
$12K |
| E0168 |
Heavyduty/wide commode chair |
912 |
877 |
$12K |
| E1038 |
Transport chair pt wt<=300lb |
2,395 |
2,348 |
$12K |
| E0165 |
Commode chair with detacharm |
1,713 |
1,640 |
$10K |
| B4035 |
Enteral feed supp pump per d |
133 |
125 |
$10K |
| E2612 |
Gen use back cush wdth>=22in |
84 |
79 |
$8K |
| A7046 |
Repl water chamber, pap dev |
1,326 |
1,297 |
$8K |
| B4152 |
Ef calorie dense>/=1.5kcal |
87 |
83 |
$8K |
| A7005 |
Nondisposable nebulizer set |
742 |
715 |
$7K |
| E1020 |
Residual limb support system |
329 |
293 |
$7K |
| E1226 |
Manual fully reclining back |
315 |
310 |
$6K |
| E0910 |
Trapeze bar attached to bed |
1,060 |
1,009 |
$6K |
| E0600 |
Suction pump portab hom modl |
449 |
434 |
$6K |
| E1161 |
Manual adult wc w tiltinspac |
13 |
12 |
$3K |
| E0100 |
Cane adjust/fixed with tip |
375 |
366 |
$2K |
| A4623 |
Tracheostomy inner cannula |
57 |
52 |
$2K |
| A7039 |
Filter, non disposable w pap |
419 |
398 |
$2K |
| A7037 |
Pos airway pressure tubing |
78 |
78 |
$996.80 |
| E0565 |
Compressor air power source |
37 |
37 |
$708.56 |
| K0739 |
Repair/svc dme non-oxygen eq |
137 |
132 |
$677.70 |
| B9002 |
Enter nutr inf pump any type |
14 |
13 |
$337.07 |
| E0244 |
Toilet seat raised |
12 |
12 |
$306.00 |
| K0052 |
Swingaway detach ftrest repl |
145 |
139 |
$292.17 |
| E0978 |
W/c acc,saf belt pelv strap |
12 |
12 |
$258.11 |
| E1031 |
Rollabout chair with casters |
24 |
24 |
$209.87 |
| A7000 |
Disposable canister for pump |
87 |
81 |
$195.98 |
| A7002 |
Tubing used w suction pump |
65 |
62 |
$65.91 |
| A7526 |
Tracheostomy tube collar |
12 |
12 |
$30.80 |
| A7015 |
Aerosol mask used w nebulize |
68 |
68 |
$26.05 |
| A7525 |
Tracheostomy mask |
12 |
12 |
$2.00 |
| E0603 |
Electric breast pump |
95 |
95 |
$0.00 |